血清视黄醇结合蛋白4水平与2型糖尿病并发急性脑梗死的相关性研究

摘要

目的：探讨血清视黄醇结合蛋白4（retinol-binding protein，RBP4）水平与2型糖尿病并发急性脑梗死的相关性。方法选取2014年6月－2015年1月在扬州大学医学院附属医院住院的30例2型糖尿病并发急性脑梗死患者、30例2型糖尿病并发陈旧性脑梗死患者、30例2型糖尿病不合并脑梗死患者、30例非糖尿病脑梗死患者及30例同期体检健康者。比较各组受检者的总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、脂蛋白（a）[LP （a）]、胱抑素C（Cyc-C）、空腹血糖（FPG）、糖化血红蛋白（HbA1c）、RBP4水平。采用Spearman相关分析RBP4的相关因素，采用二分类Logistic回归分析2型糖尿病并发急性脑梗死的影响因素。结果①5组受检者收缩压（ SBP）、FPG、TG、HDL-C、Cyc-C、HbA1c、RBP4水平差异有统计学意义（P＜0.05）；其中2型糖尿病并发急性脑梗死组患者血清RBP4水平均高于对照组、2型糖尿病并发陈旧性脑梗死患者组、2型糖尿病患者组、脑梗死患者组。②Spearman相关分析显示，血清TG、Cyc-C水平均与RBP4呈正相关（r值分别为0.309和0.176，P值均＜0.05），血清HDL-C水平与RBP4呈负相关（r值为－0.249，P＜0.01）。③二分类Logistic回归分析显示，RBP4与2型糖尿病并发急性脑梗死存在回归关系（OR＝1．188，P＜0.05），收缩压（SBP）和舒张压（DBP）与2型糖尿病并发陈旧性脑梗死存在回归关系（分别为OR＝1．133，P＜0.01；OR＝0.879，P＜0.05）。结论高血清RBP4水平可能是2型糖尿病并发急性脑梗死的危险因子之一，血清RBP4升高与血脂偏高有关。%Objective To explore the relation between serum retinol binding protein 4 ( RBP4 ) level and type 2 diabetes mellitus patients combined with acute cerebral infarction.Methods The patients who were admitted to the Affiliated Hospital of Yang-zhou University from June 2014 to January 2015, were selected as study subjects.30 patients with type 2 diabetes mellitus and acute cerebral infarction were included in A group.30 patients with type 2 diabetes mellitus and old cerebral infarction were included in B group.30 patients with type 2 diabetes mellitus were included in C group.30 patients with cerebral infarction were included in D group and 30 healthy people were included in control group.The levels of TC, TG, LDL-C, HDL-C, lipoprotein(a), cystatin C, fasting plasma glucose(FPG), HbA1c, RBP4 were compared among groups.The relevant factors for RBP4 levels were analyzed by Spearman correlation analysis.The influencing factors for type 2 diabetes complicated with acute cerebral infarction were analyzed by a binary Logistic regression model.Results There were differences in serum levels of SBP, FPG, TG, HDL-C, cystatin C, HbA1c and RBP4 among 5 groups (P<0.05).The serum RBP4 levels in A group were significantly higher than those in control group, B group, C group and D group.According to result of Spearman correlation analysis, serum levels of TG and cystatin C were positively correlated with RBP4 level (r value was 0.309 and 0.176, respectively;P<0.05);serum levels of HDL-C was negatively correlated with RBP4 level (r value was -0.249;P<0.01).According to result of binary Logistic regression model, there were remarkable regression rela-tionships between type 2 diabetes complicated with acute cerebral infarction and RBP4 (OR=1.188, P<0.05).Also, there were re-markable regression relationships between type 2 diabetes complicated with old cerebral infarction and SBP (OR=1.133, P<0.01), DBP(OR=0.879, P<0.05).Conclusion The serum RBP4 levels increased in type 2 diabetes mellitus patients combined with acute cerebral infarction, which indicated that RBP4 can be used as a predictor of type 2 diabetes complicated with acute cerebral infarction.The serum levels of TG and cystatin C were positively correlated with RBP4 level, the serum level of HDL-C was negatively correlated with RBP4 level, which suggested the serum RBP4 are associated with high blood lipids.